Abstract

BackgroundMechanical ventilation (MV) used in patients with acute respiratory distress syndrome (ARDS) can cause diffuse lung inflammation, an effect termed ventilator-induced lung injury, which may produce profound pulmonary fibrogenesis. Histone deacetylases (HDACs) and serine/threonine kinase/protein kinase B (Akt) are crucial in modulating the epithelial–mesenchymal transition (EMT) during the reparative phase of ARDS; however, the mechanisms regulating the interactions among MV, EMT, HDACs, and Akt remain unclear. We hypothesized that trichostatin A (TSA), a HDAC inhibitor, can reduce MV-augmented bleomycin-induced EMT by inhibiting the HDAC4 and Akt pathways.MethodsFive days after bleomycin treatment to mimic acute lung injury (ALI), wild-type or Akt-deficient C57BL/6 mice were exposed to low-tidal-volume (low-VT, 6 mL/kg) or high-VT (30 mL/kg) MV with room air for 5 h after receiving 2 mg/kg TSA. Nonventilated mice were examined as controls.ResultsFollowing bleomycin exposure in wild-type mice, high-VT MV induced substantial increases in microvascular leaks; matrix metalloproteinase-9 (MMP-9) and plasminogen activator inhibitor-1 proteins; free radical production; Masson’s trichrome staining; fibronectin, MMP-9, and collagen 1a1 gene expression; EMT (identified by increased localized staining of α-smooth muscle actin and decreased staining of E-cadherin); total HDAC activity; and HDAC4 and Akt activation (P < 0.05). In Akt-deficient mice, the MV-augmented lung inflammation, profibrotic mediators, EMT profiles, Akt activation, and pathological fibrotic scores were reduced and pharmacologic inhibition of HDAC4 expression was triggered by TSA (P < 0.05).ConclusionsOur data indicate that TSA treatment attenuates high-VT MV-augmented EMT after bleomycin-induced ALI, in part by inhibiting the HDAC4 and Akt pathways.

Highlights

  • Acute respiratory distress syndrome (ARDS) is characterized by a severe inflammatory reaction and epithelial injury followed by fibroblast proliferation and extracellular matrix (ECM) deposition, which requires mechanical ventilation (MV) to provide life support [1, 2]

  • In Akt-deficient mice, the MV-augmented lung inflammation, profibrotic mediators, epithelial– mesenchymal transition (EMT) profiles, Akt activation, and pathological fibrotic scores were reduced and pharmacologic inhibition of HDAC4 expression was triggered by trichostatin A (TSA) (P < 0.05)

  • Our data indicate that TSA treatment attenuates high-tidal volume (VT) MV-augmented EMT after bleomycin-induced acute lung injury (ALI), in part by inhibiting the HDAC4 and Akt pathways

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Summary

Introduction

Acute respiratory distress syndrome (ARDS) is characterized by a severe inflammatory reaction and epithelial injury followed by fibroblast proliferation and extracellular matrix (ECM) deposition, which requires mechanical ventilation (MV) to provide life support [1, 2]. Histone deacetylases (HDACs) are crucial posttranslational modifiers that remove acetyl groups from histones and transcription factors, and epigenetically regulate the expression of various genes [11, 12]. HDAC4 is necessary for the TGF-β-induced fibroblast to myofibroblast transition because it inhibits histone acetylation [18, 19]. Mechanical ventilation (MV) used in patients with acute respiratory distress syndrome (ARDS) can cause diffuse lung inflammation, an effect termed ventilator-induced lung injury, which may produce profound pulmonary fibrogenesis. We hypothesized that trichostatin A (TSA), a HDAC inhibitor, can reduce MV-augmented bleomycininduced EMT by inhibiting the HDAC4 and Akt pathways

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